三种鼻腔填塞材料在鼻内镜手术中的疗效比较

目的:探讨三种鼻腔填塞材料在鼻内镜手术中的应用效果。方法:2004年1月至8月为慢性鼻窦炎、鼻息肉75例行内窥镜鼻窦手术,男49例,女26例,平均42岁。Ⅱ型2期36例,Ⅱ型3期21例,Ⅲ型18例。局部或全身麻醉下行Messerklinger鼻窦内窥镜手术,术后随机予以凡士林油纱条、Merocel高分子止血棉、瑞纳凝胶快速止血材料中的一种填塞鼻腔,每组25例,48~72 h后取出填塞物,观察患者鼻痛、头痛的程度及取出填塞物后的渗血情况,判断疗效。结果:凡士林油纱条组80%的患者出现鼻痛、头痛等症状,64%的患者抽出鼻腔填塞物后有渗血;瑞纳凝胶快速止血材料组60%的患者出现鼻痛、头痛等症状,12%的患者抽出鼻腔填塞物后有渗血;Merocel高分子止血棉组44%的患者出现鼻痛、头痛等症状,24%的患者抽出鼻腔填塞物后有渗血;三组比较差异有统计学意义(P<0.05)。结论:三种鼻腔填塞材料中凡士林油纱条疗效可靠,价格低廉,但痛苦明显;Merocel高分子止血棉、瑞纳凝胶快速止血材料止血效果好,痛苦小,但价格略昂贵,临床应用中可视情况而定。

Effect of three nasal packing materials in functional endoscopic sinus surgery

Objective: To investigate the effect of three nasal packing materials in functional endoscopic sinus surgery.Methods: Seventy-five patients with chronic rhinosinusitis and nasal polyp were treated with functional endoscopic sinus surgery.After surgeries,voseline strips gauze,Merocel and Rapid-Rhina were used at random and were taken out 48-72 hours later.Results: About 80% of the patients in group of voseline strips gauze felt pain,60% of them still had bleeding after being taken out the nasal packings;about 60% of the patients in group of Rapid-rhina felt pain,and 12% of them had bleeding after being taken out the nasal packings;44% of the patients in group of Merocel felt pain,and 24% of them had bleeding after being taken out the nasal packings.Conclusions: All the three nasal packing materials have good effect.Voseline strips is cheap but brings much pain to the patients,while Merocel and Rapid-rhina makes patients feel comfortable but is expensive.